Cigarette, cigar, and pipe smoking and the risk of head and neck cancers: Pooled analysis in the international head and neck cancer epidemiology consortium

Annah Wyss, Mia Hashibe, Shu Chun Chuang, Yuan Chin Amy Lee, Zuo Feng Zhang, Guo Pei Yu, Deborah M. Winn, Qingyi Wei, Erich M. Sturgis, Renato Talamini, Luigino Dal Maso, Neonila Szeszenia-Dabrowska, Elaine Smith, Oxana Shangina, Stephen M. Schwartz, Chu Chen, Stimson Schantz, Peter Rudnai, Mark P. Purdue, Jose Eluf-NetoJoshua Muscat, Hal Morgenstern, Pedro Michaluart, Ana Menezes, Elena Matos, Ioan Nicolae Mates, Jolanta Lissowska, Fabio Levi, Philip Lazarus, Carlo La Vecchia, Sergio Koifman, Rolando Herrero, Richard B. Hayes, Silvia Franceschi, Victor Wünsch-Filho, Leticia Fernandez, Eleonora Fabianova, Alexander W. Daudt, Maria Paula Curado, Paolo Boffetta, Xavier Castellsague, Marcos Brasilino De Carvalho, Gabriella Cadoni, Stefania Boccia, Paul Brennan, Andrew F. Olshan

Research output: Contribution to journalReview articlepeer-review

199 Scopus citations


Cigar and pipe smoking are considered risk factors for head and neck cancers, but the magnitude of effect estimates for these products has been imprecisely estimated. By using pooled data from the International Head and Neck Cancer Epidemiology (INHANCE) Consortium (comprising 13,935 cases and 18,691 controls in 19 studies from 1981 to 2007), we applied hierarchical logistic regression to more precisely estimate odds ratios and 95% confidence intervals for cigarette, cigar, and pipe smoking separately, compared with reference groups of those who had never smoked each single product. Odds ratios for cigar and pipe smoking were stratified by ever cigarette smoking. We also considered effect estimates of smoking a single product exclusively versus never having smoked any product (reference group). Among never cigarette smokers, the odds ratio for ever cigar smoking was 2.54 (95% confidence interval (CI): 1.93, 3.34), and the odds ratio for ever pipe smoking was 2.08 (95% CI: 1.55, 2.81). These odds ratios increased with increasing frequency and duration of smoking (Ptrend ≤ 0.0001). Odds ratios for cigar and pipe smoking were not elevated among ever cigarette smokers. Head and neck cancer risk was elevated for those who reported exclusive cigar smoking (odds ratio = 3.49, 95% CI: 2.58, 4.73) or exclusive pipe smoking (odds ratio = 3.71, 95% CI: 2.59, 5.33). These results suggest that cigar and pipe smoking are independently associated with increased risk of head and neck cancers.

Original languageEnglish (US)
Pages (from-to)679-690
Number of pages12
JournalAmerican journal of epidemiology
Issue number5
StatePublished - Sep 1 2013

All Science Journal Classification (ASJC) codes

  • General Medicine


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